Maternal Diet during Exclusive Breastfeeding can Predict Food Preference in Preschoolers: A Cross-Sectional Study of Mother- Child Dyads in Enugu, South-East Nigeria

Background: The relationship between food preference in early childhood and prenatal exposure to flavor in the amniotic fluid is well documented. Although its association with flavor transmission in the breast milk has also been noted, it is poorly reported in this country. Objective: The present study aims to determine the relationship between mothers’ dietary exposure during exclusive breastfeeding and food preference in their preschool-aged children. Methods: Two hundred and twenty (220) mother-child dyads who met the study criteria were enrolled. A pre-tested, structured questionnaire was administered to the mothers. The relationship between maternal consumption of flour-based snacks and staple foods during exclusive breastfeeding and the child’s preference for these foods was determined using risk estimates. After controlling for potential confounders, logistic regression was used for multivariate analysis. Statistical significance was determined at p < 0.05 and all the risk estimates were presented as odds ratios (OR) at 95% confidence intervals (CI). Results: The relationship between daily maternal exposure to staple foods during exclusive breastfeeding and the children’s preference for this variety of food was not statistically significant (p = 0.847, OR= 1.083, 95% CI = 0.481-2.437). However, the children’s preference for flour-based snacks was significantly related to weekly or fourth-nightly maternal exposure to similar diet during exclusive breast feeding (p = 0.035, OR = 2.405, 95% C.I = 1.064 - 5.435). Conclusion: Transmission of flavor in the breast milk may contribute in shaping children’s feeding behavior early in life

A Comparison of the Performance of the Midarm Circumference and the Nelson Weight Estimation Formulas in Nigerian Children

Background: In emergencies, two commonly used weight estimation methods are Nelson and mid‑arm circumference (MAC)‑based formulae. Nelson’s method requires the child’s age while the MAC formula offers weight estimation without any prior details of the child, which is useful in our environment due to the lack of proper vital statistics documentation. Methodology: We measured the weight, height, and MAC of 1390 children aged 1–12 years. Values got from the measurements were substituted in MAC and Nelson formulae for weight estimation. The estimated weights were compared to the actual weights of the children. Results: Atotal of 1390 children were enrolled. The mean of enrolled children’s actual weight was significantly higher than the mean weight estimated using MAC and Nelson formula. MAC method overestimated weight in children 1–7 years and underestimated weight in those 8–12 years old. On the other hand, the Nelson formula underestimated weights in children 2–11 years and overestimated weight in 1 and 12-year olds. Conclusions: Both the MAC and Nelson method have their deficiencies in weight estimation. Though the Nelson formula  appears slightly more accurate than the MAC, weight estimates from both methods were mostly within the actual weight agreement limits. Keywords: Actual weight, children, comparison, formulae, mid‑arm circumference, nelso

A call to bridge the diagnostic gap: diagnostic solutions for neonatal sepsis in low- and middle-income countries.

Low- and middle-income countries (LMICs) bear the greatest burden of neonatal mortality, with sepsis being a major contributor. Non-specificity of signs, and the absence of a definitive diagnostic present a challenge to the identification of sepsis and can lead to underdiagnosis or overdiagnosis, both of which can have harmful consequences. As early intervention can be life-saving, sepsis protocols, which commonly include empiric therapies, result in the overuse of antibiotics and the development of antimicrobial resistance. Affordable and accurate diagnostic tests that can detect neonatal sepsis at or near the point of care could contribute to reduced sepsis-related mortality in LMICs and support antimicrobial stewardship. A screening test to guide referral to hospital from primary care and an in-hospital test to guide treatment decisions, are high priorities. Considerable investment will be needed to support the development of these diagnostics

Validation of Pediatric Height Estimation Formulae in Suburban Communities in South-east Nigeria: A Cross-sectional Study.: Validation of Pediatric Height Estimation Formulae

Background: Height measurement is one of the common essential anthropometric measurements in clinical pediatrics. The most accurate method of determining a child  height is to  measure the height. However, in emergency situations and some resource limited settings, obtaining the actual height of a child may not be feasible hence the need to estimate. The most common age-based formulae for height estimation in children is 6n + 77 where n = age in years. The accuracy of this height estimation formulae has not been assessed in developing setting like ours with high prevalence of malnutrition. This study therefore sought to evaluate the accuracy of the height estimation formula in children in communities across Enugu southeast Nigeria. Method: Children 2-12 years old who met the inclusion criteria were enrolled over 12 months from three of the 17 Local Government Area of Enugu State. Height was measured using a standard stadiometer and estimated height was calculated 6n + 77. Data collected was analyzed using SPSS. Result: Of the 4046 children enrolled, majority (86.1%) were of normal height for age while 2.6% were stunted. The formula underestimated height of children in younger age bracket and overestimated height in older children. Overall, the estimated height using the formula was within ±10% agreement of the actual height of surveyed children in 77.0% of children surveyed. Conclusion: The 6n + 77 formula is a reasonable but not entirely accurate for height estimation for children in our setting. Keywords: Children, Height, Estimation, Accurac

Nutritional status of primary school children in Enugu, Nigeria using anthropometric measurements

Background: The survival and wellbeing of children is largely dependent on nutrition. Malnutrition in children can co-exist as under- and over-nutrition in the same population with varying attendant medical risks.Objective: The aim of this study was to determine the nutritional status of primary school children in Enugu North LGA, using anthropometry.Methodology: This was a cross sectional descriptive study involving primary school children aged 6-12years in Enugu. Subjects were selected using multistage sampling technique over a 3 month period. Weight and height were measured using a digital scale and a wooden stadiometer, respectively. Weight-for-age, Height- for -age and Body Mass Index-for-age z scores were then derived using the new WHO reference standards.Results: Three hundred and forty eight (40.4%) children were recruited from public schools while 512 (59.6%) were recruited from private schools. The mean age of the study subjects was 9.18 ± 1.79 years. Seven (0.8%) children were stunted, 26 (3.3%) wasted and 28 (3.3%) underweight. Overweight and obesity were observed in 73 (8.5%) and 35 (4.1%) children, respectively. Under-nutrition was more prevalent in children aged 12 years (P= 0.001) whereas males were found to be more obese than females (P= 0.02).Conclusion: There was a low prevalence of under nutrition. However, overweight and obesity appear to be emerging as nutritional problems.Keywords: Nutrition, Obesity, Stunting, Underweight, Wasting, Anthropometr

Zinc levels in HIV-positive children at the University of Nigeria teaching hospital

Background: Zinc is an abundant trace element in the body involved in many physiological processes. Its deficiency has been described in HIV-infected children, especially in advancing illness. This study, therefore, seeks to assess zinc levels in HIV-positive children attending the HIV clinic at University of Nigeria Teaching Hospital (UNTH). Materials and Methods: This was a descriptive, cross-sectional study among HIV-positive children aged 5–60 months attending the HIV clinic at UNTH. A 100 participants were enrolled from August 2013 to May 2014. Data were obtained using a pro forma developed by researchers, and blood samples were collected and analysed using an absorption spectrophotometer. Serum zinc level deficiency was defined as the values <80 μg/dL. Data analysis was conducted using the SPSS version 26. Results: Most participants were males (53.0%). Their mean age was 47 months (standard deviation = 15.7). The median serum zinc level was 55.5 μg/dL (IQR = 35.0–84.8). The majority of the participant (72%) had zinc deficiency. There was a statistically significant relationship between serum zinc level and participants' socioeconomic status (P < 0.05) – higher socioeconomic status was associated with higher zinc levels. Conclusion: The study showed a high prevalence of zinc deficiency in children living with HIV, with a significant relationship between serum zinc level and the participants' socioeconomic status. There is a need for zinc supplementation for HIV children, especially the indigent ones

Perception of donor breast milk and determinants of its acceptability among mothers in a developing community: a cross-sectional multi-center study in south-east Nigeria

Abstract Background Due to the health and economic benefits of breast milk, the World Health Organization (WHO) recommends that for infants who cannot receive breast milk from their own mothers, the next preferred option is donated breast milk. This recommendation is however rarely practiced in most developing countries where donor milk is not widely accepted. Methods This cross-sectional multi-center study enrolled mothers attending antenatal or pediatric clinics in six tertiary institution in south-east Nigeria using purposive and convenient sampling method. Data collection was done using pretested questionnaires. The study aimed to assess the knowledge, acceptability and willingness to donate breast milk and/or use donated breast milk for their infants It also explored factors that determine this behavior. Results A total of 1235 mothers participated; 39% (480/1225) have heard about the concept of donor milk, while only 10% (79/759) and 7% (81/1179), respectively, had adequate knowledge of the concept and policy on donor milk. Sixty percent indicated willingness to use donor milk or donate breast milk if need arises. Respondents with lower age (p = 0.049) and with higher occupational status (p = 0.001) were more likely to have adequate knowledge of donor breast milk, while respondents with lower educational attainment (p = 0.002) and those who are non-Christians (p = 0.004) were more likely to request financial inducement for donating their breast milk. Adequate knowledge of the concept of donor milk (p = 0.001), preference of donor milk to infant formula (p = 0.001) and requirement of financial remuneration (p = 0.001) were the only significant predictors of willingness to donate and/or receive donated breast milk. Conclusion The knowledge of the concept of donor breast milk and awareness of policies regulating its practice in Nigeria is low, but the prospect of its acceptability is high among mothers surveyed in south-east Nigeria. Targeted public education by relevant government agencies in collaboration with clinicians, community and religious leaders about the concept of donor breast milk to families may help increase the acceptance and practice of donating breast milk and/or use of donated breast milk among mothers in the region